CTQs in health care

During my course of study of the health care services I acknowledge some of the factors that are critical to Quality and on which most of the success of the organization depends. Though the scope of the study is much limited to the Delhi, NCR but there are some general issues which I believe are sensitive and to be considered.

Quality has been shown to be an important element in the consumers' choice of hospitals thereby emerging need to improve the quality of healthcare services. Healthcare is one of India’s largest sectors, in terms of revenue and employment, and the sector is expanding rapidly.

The Reality I came across:

1. Centers of excellence in health care delivery are limited to drive healthcare standards because of the poor condition of the infrastructure.
2. Of the 15,393 hospitals in India in 2002, roughly two-thirds (roughly 10,000) were public provided only basic health-care.
3. Barring a few like AIIMS, PGCMS etc public health facilities are inefficient, inadequately managed and staffed, and have poorly maintained medical equipment.An enormous amount of private capital will be required in the coming years to enhance and expand.
4. The principal responsibility for public health funding lies with the state governments, which provide about 80% of public funding. The government contributes another 15%, mostly through national health programs.

As Health care is a service organistion and the basic issue regarding any o fthe service organisation is that the outcome is intangible so there arises the criticality which leads in how to determine the quality in services. For this reason the study is done with the help of The ServQual Model [Parasurman, Zeithaml & Berry (1988)] and out of 5 Gaps 2 major gaps are identified which are:

Gap3: Service specifications versus service delivery

• poor employee-job fit and poor technology-job fit,
• inappropriate supervisory control systems,
• lack of perceived control.i.e the doctors, patients to nurses ratio, technical staff and medical equipments and proper trained staff thereof,
• control on proper standardized waste management, hygiene and specified system for disinfecting the area.
• the smaller hospitals or nursing homes were found to be just aware of the facts but refrained from using as these methods increased there expenses.

Gap5: The discrepancy between customer expectations and their perceptions of the service delivered

• as a result of the influences exerted from the customer side and the shortfalls (gaps) on the part of the service provider.
• In this case, customer expectations are influenced by the extent of personal needs, word of mouth recommendation and past service experiences.

According to my analysis the core of health services depends on the Assurance on the part of quality provided by an organization.

Four core principles

Focus on the client : external & internal customers.

Focus on systems and processes: understand the service delivery system and its key service processes in order to improve them.

Focus on measurement : to analyze processes, identify problems, and measure performance in order to identify opportunities for improvement to initiate QA efforts, detect and assess problems, verify possible causes of problems and show if a quality intervention yielded improvement and by how much.

Focus on teamwork : a team approach to problem solving and quality improvement.